Color fundus photographs of a study eye during follow-up showing an example of pigment clumping emerging de novo in an eye with IMT2. At baseline visit (A), clinical features of IMT2 (telangiectasis, retinal crystals, abnormal venules, retinal graying) were present but without evidence of pigment clumping. At 33 months (B), separate clumps of pigment emerged de novo in the temporal perifoveal region, in some areas overlying perifoveal venules (arrowhead). At 75 months (C), these clumps had each increased in size and were partially coalescent.